Deciding how to deliver? Please help... Sensitive nature

[Bearberry]

Birth

Firstly this is really long, so greatly appreciate anyone taking the time to wade through. I did post on the topic a few months back in less detail, so apologies for the repetitive element - but I really want some help! In a nutshell my first pregnancy ended in April last year when I delivered our DD at 20 weeks at home. The pregnancy had involved a lot of scary moments and bleeding throughout. I went to two local A&E units the day I lost her, having contractions (first pregnancy as I wasn't sure at the time what was happening) and was turned away as cervix was closed, only for her to arrive a few short hours later. I am now pregnant again, currently 36 weeks (consultant led although no explanation found for what happened with DD1) and due another DD - almost exactly one year on (lost DD1 on 26/4, DD2 due 25/4, which is also unhelpful).

My main fears relate to the previous pregnancy, although I know so far this pregnancy has been very different. I've been having counselling for the last 6 months relating to the bereavement and the trauma I encountered. However the entire pregnancy has been a very anxious time for me, and I find I am constantly having to fight negative thoughts about the outcome. I basically feel terrified each day that something will go wrong and this baby will not survive. As a result of months of feeling this way, I know feel desperate for an end point, and some element of control over the delivery. I am very keen to reduce and chances of distress or problems occurring during the labour as I feel I am emotionally unable to deal with anything other then a straightforward situation. This in itself is very stressful for me as I understand things cannot be controlled in this fashion. My fear throughout the pregnancy has been that my body will once again inexplicably fail me, and the baby will come to early and not survive, so have spent the last few months willing her to stay put. Now I am reaching full term, and whilst I know she is ok, I want her out as quickly and safely as possible, before something has the opportunity to go wrong. Because of this and because of her expected size (measuring 95th centile) and problems this could result in for an overdue delivery I am keen not to go over due.

I spoke to registrar before about the option of an induction if I reach my due date and don't naturally go into labour before then. I like the idea of this in the sense I won't go overdue, and can have a date booked in and therefore an end date in my mind (which seems important for psychologically surviving these last few weeks). This also helps with the trauma I feel relating to actually labouring, and this will be undertaken exclusively within the hospital. My concerns however are that the induction is more likely to lead to a baby in distress, interventions or a emcs.

My concerns relating to a natural spontaneous labour are as follows:

1. I delivered previous baby at home, alone, with no pain relief - after being sent away from two hospitals with 'stretching pain'. The experience was hugely traumatic and life changing for me. Despite 6 months of specialised counselling I still feel very scared and anxious about going into labour and have a huge fear of not being able to make it to hospital and delivering at home and something going very wrong.
2. I am very scared of going overdue and encountering problems relating to that and/or her size
3. The complete lack of control over the situation is unsettling given the circumstance. I have no idea when I might go into labour or how this might work, I am very keen to avoid any situation where the baby becomes distressed. I appreciate that how a labour will go is basically luck and can't be predicted.

Regardless of the above I know that a natural spontaneous labour has a decent chance of being the best and safest situation for me and the baby, and that I have no reason to believe I won't have a straightforward, easy labour & delivery.

The last alternative as I understand it would be an elcs, which is what I am swaying heavily towards at present. I have read extensively about this and from egg I understand the risks of an elcs to the baby and a spontaneous natural labour are at a very similar level. The obvious downside is the recovery time as I appreciate this is a major operation. The elcs would offer me control in that I would have a specific date to work towards and takes away the concerns of a interventions which which could happen with an induction. I feel it's the safest way and offers the highest odds from this external position that the baby will arrive safely and in a non-traumatic way. I do appreciate that not all operations go smoothly and I could be one of the unlucky ones in that sense. I feel in some senses that I would be failing by having a elcs, and that I should be psychologically strong enough to push through for natural labour.

Right, this is basically the huge rambling circle my brain is doing re birth. I would REALLY appreciate any guidance here as I just feel at a loss as to what to do for the best. My DH is pushing for a natural labour as he wants me to avoid surgery. I understand that if I do decide to push for a elcs I need to be reasonably forceful in my choice, and I just don't feel I have enough conviction one way or another at present. My counsellor thinks I should go for the elcs and has totally validated my feelings but in her absence over the last week I have once again become unsure. Urgh.

I tried to make a midwife appointment to discuss options but they are totally booked up and not very helpful. I have a consultant appointment Wednesday (although may end up being with the registrar when I get to here) and I would really like to have a constructive conversation about it then, but at the moment feel like a total flake.

If I was in your situation I would go for a planned CS. One of friends insisted on this and it was so calm and quick. He H cut the cord and she did skin to skin immediately.
Sorry for what you have had to go through but well done on getting this far.

Induction of labour can be very successful and straight forward if the body is ready. I have had two successful inductions at 36 and 37 weeks due to complications. Both babies normal deliveries. I'm not sure I'd be so keen if I weren't ready, I'd likely end up choosing CS.

So very sorry to hear about your first baby.

Congratulations on reaching 36 weeks with your current pregnancy. I have some idea of how worrying it must have been for you throughout, as DS1 was born at 24 weeks. We were extraordinarily lucky to take him home eventually.

I too was terrified of giving birth the second time round, because I too had been turned away from the hospital when I first went into labour with DS1 (I was a paranoid first time mother who was wasting their time. Apparently). I was enormously lucky that I just happened to be back there seeing my consultant when everything happened. Anyway, with DS2 I had similar fears to you about being able to have some degree of control over the situation. My lead consultant - who was a total genius but with no bedside manner - told me in no uncertain terms that there was absolutely no way that he'd induce me early or give me an ELCS, as he'd done an amazing job getting me a nice long pregnancy and he wasn't having it shortened for any reason other than a natural one. However my next appointment was with his number 2 in charge - a really lovely lady who totally understood my fears and agreed to an induction at 38 weeks. As it was, DS2 decided to turn up two days earlier, and got stuck at the last minute so he was an EMCS. The CS was much more manageable and less painful than I'd expected, I just kept on top of the painkillers and managed pretty well. I was driving again 4 weeks later.

If I was going to have another child I would definitely ask for an ELCS. You must surely have every reasonable right to request one, and if you ask a grumpy consultant and they say no then try again with a friendlier one! Seriously though I wish you all the very best.

I chose to have a elcs after giving birth naturally twice as I had various fears about another vaginal delivery (nothing as traumatic as your reasons). The initial consultant refused to even discuss it so I swapped care and had a hugely sympathetic obstretrician who was more than happy to do it given my reasons. I can honestly say it was my best birth. It's calm, controlled and I didn't feel utterly exhausted afterwards. I won't lie, the next day was agony but after that each day got better and I was pretty much doing everything by week 3 (including driving).

As far as I am aware they don't generally like to do an elcs before 39 weeks because of the risks to baby so even if you do decide to have a section you needs contingency plan/birth plan in case you go into labour in the next 3 weeks.

When you go for your next appointment ask the receptionist if you can see the consultant rather than the reg. you may need to wait longer but if they are in clinic then you should be able to see them. Good luck.

Thank you everyone, for such kindness, I'm seriously welling up here! I can't explain how lovely it is to feel supported on this topic

Sycamore, that sounds like a scary experience, and is really what I am afraid of when it comes to an induction. Although I think it will be a comfort to some extent to be in hospital, and have access to medical professionals I am terrified of baby becoming distressed and needing forceps or an emcs. I genuinely don't know how I would be able to mentally handle a deteriorating situation.

Kitty – I remember your story from before, I am so sorry about your dd2 and about ds, that’s unbelievably shit news and so incredibly unfair. Big hug and

Kiki22 – so sorry to hear about your grandad. I lost mine 2 weeks ago after an short illness with cancer. We were very close, he was like a father to me, and its such a strange situation watching someone you love die as you visibly grow a life inside you. It felt very intense and surreal. His death is partly the reason I am swinging so much towards a elcs now as well. Grieving for him is sapping the last of my emotional strength and I just feel like I need someone to make everything OK and hand me my baby, happy and healthy.

Although I know this pregnancy has progressed significantly further, and that at 36 weeks even if I ran into difficulties now and had to deliver she would likely be fine, that’s little comfort to me. I guess because the worst has happened before the fear that it will happen again, and at any stage is very real. I know exactly how it felt so its not some far removed, dismiss-able fear but something I feel is almost more likely to happen then not. And each day, week etc that progresses I feel the stakes are higher and that things are reaching a fever pitch. Things like being on mat leave now (nature of my work means I had to finish quite early) and having hospital bag packed make everything feel very real and very scary.

Thank you everyone, for validating how I am feeling. I certainly feel now that a elcs is the best route, and that I am reasonable in feeling that way and taking this option. I know my concerns around letting people down and not being strong enough or worthy of a elcs are unfounded, I am really surprised by how much pressure I feel to have this idealistic birth. I'm not sure where it comes from and I have a tendency to be overly harsh on myself so it could all just be in self generated. I had a big heart to heart with my DH after my final counselling session last week and told him I was going to request a elcs and exactly the reasons why. Although he wasn't delighted he did confirm he will support me 100% and be by my side and that he could understand my reasons. I haven’t told him that I had become unsure again over this last week so as far as he knows it's already decided. Now I just need to put my case to the consultant and get one booked in. I have no idea how straight forward that will be and from what I've read it really does vary consultant to consultant but I will certainly ask for a referral to another dr if he is unwilling. I am hoping the fact I have been having counselling throughout the pregnancy to try and combat these issues and that my counsellor thinks a elcs would be best, will go in my favour. I will definitely ask to see the consultant this time and yes to the suggestion of writing down points and questions, I think that will help stop me flapping, digressing or being rail roaded. Once I feel convinced I have the confidence to be assertive, it's just when time passes and I'm left alone in my own head, I tend to talk myself out of an elcs and condemn myself for not doing things naturally. I'm my own worst enemy in this regard and need to stop self sabotaging.

Thank you to everyone who shared their experiences of birth with me, its really great to hear – especially those who have advised the recovery time for the cs isn’t too terrible!

Glad you're feeling stronger. A bit late but I would go with elcs too. My consultant was happy to go down my preferred route and when I wavered she asked how I thought I'd react if there were any minor complications during birth. I knew I'd panic so we went for a nice controlled birth via elcs.
Good luck.

I'm glad you are feeling strong. One other thing, you mentioned about your husband cutting the cord. I have no idea if this is possible in a C section - I'm guessing not due to the need to preserve the sterile field - but for the birth of our child, my baby was born and I was cuddling him on my chest with my husband cooing over us both when the midwife asked if he'd like to cut the cord. He was startled out of his reverie, agreed and cut it in about half a second with no particular ceremony or symbolism, he just wanted to get back up to focus on the baby's little face. I've asked him about it since and he says he nearly would have preferred not to cut it and just continue with the cuddles. He does not think of it at all as some magical mystical moment. So do not feel like your husband may be missing out on some big deal if your section means he does not get to cut the cord.

Best wishes for your appointment. And for the birth of course.

So glad to hear you are feeling stronger. In terms of language to use to make your case to your consultant - I would repeat to them that you were deeply traumatised by the last birth, have had specific counselling in relation to this and that both you and your counsellor agree that minimising any further risk of repeat trauma is essential for your mental and emotional health, hence requesting elcs. As an ex health worker I've often found that using their kind of clinical language helps to get the message across to medical professionals.

Sycamore, good point, im sure the cutting of the cord lark isn't nearly as relevant as it seems. DH is quite keen on the idea but then I think when it comes to it, he will just be so delighted she is here it will be totally irrelevant in the scheme of things.

lokah, thanks for the advice I shall definitely use that. My counsellor said something similar to be fair, I'm just hoping it won't be too much of a battle really

I lost my dd at 20 weeks last year - had to be induced after finding no heartbeat at the 20 week scan. I have also had 3 earlier 'natural' miscarriages. They have all been extremely painful and I felt I had no control over each one. I don't feel there was anything 'natural' about any of them.

I had my ds by cs 4 years ago due to a low lying placenta. It was great. I knew when it was going to happen, was looked after brilliantly by the hospital staff, and was up and about within a couple of days.

I am now 30 weeks and have been asked about delivery this time round, if I get that far (still can't believe I will!) Without a second thought, I have asked for an elcs again. After 4 miscarriages, I just do not trust my body to do what it should do. And I cannot bear the thought of the pain and contractions as I just as associate this with loss and heartbreak.

It is a totally personal choice but I totally understand why you wouldn't want to go through a 'natural' birth after your loss which, as you say, you are still working through. However, I thought I'd just share my own feelings on this as I think we are probably going through similar situations.

I hope that whatever you chose, everything goes well and that you soon have your dd safe in your arms. X

Wishing you a constructive conversation with your consultant.

Fwiw, I went to see my consultant all armed with facts and studies and NICE guidelines, ready to demand my VBAC and was totally wrong footed by him saying 'well, which way would you like to deliver this baby?' . So I hope you will find equal understanding and compassion. IMO the single most important thing is to feel listened to and heard; it is so valuable to fully trust the team who are looking after you.

You (and others on this thread ) have been through such heartbreak and you sound so very scared AND hard on yourself, my heart aches for you. I truly hope you will feel a sense of joy and relief once you hold your baby safely in your arms - and won't find the newborn phase too frightening. I am really glad you had specialist counselling and have found support in that.

I just asked DH about the whole chord-cutting thing and he said 'yes, it seemed important at the time, now I can barely remember it'. And he did of course not cut the chord with DS2 when I had the emCS - that has not changed how he feels about him one bit

Thanks OP I'm totally sure about my decision to have an elcs but part of me hopes I go into labour and baby pops out easily before I have a chance to be taken to theatre which I know is crazy but I felt like I would like to prove I can do it, I think it's quite normal especially when you hear all the negative to posh to push stuff as if being cut open is a walk in the park. My consultant was great totally happy for me to go ahead he did point out opting for an elcs doesn't mean it's set in stone its not a contract you can change your mind right until you get to theatre.

The most important thing is your mental health and well-being its so hard to take care of a newborn without being emotionally battered on the of all the normal newborn emotions.

What a difficult pg you must have had. You are being so strong.

Have the section. I had a section with my second after losing my first due to a complicated labour. I'm pg with number 3 now and the section has been booked. It's all very controlled, yes you are sore and need to take it easy, but it's a good reason to sit and cuddle your baby and not move. Keep on top of the pain with whatever pain killers they give you. Also it didn't effect my ability to breast feed, if that's something you wanted to do. Milk was fine.

Good luck, whatever decision you make. I totally get the wanting to know when and how, I feel exactly the same, and it's a weight off my mind knowing the section is happening.

I had a semi-elective c section on Saturday night due to a failed induction. DH cut the cord, the staff were fabulous and I am up and about already with some pain but nothing that isn't manageable with paracetamol and ibuprofen. Our c section was a lovely experience and although I'd have preferred a natural birth I am thrilled with how it went. You need to be comfortable with your decision op and go with whatever is best for you and your baby.

Just wanted to add a quick update after my consultant appointment today. I ended up seeing a different consultant to previously, however he was very pleasant and easy to talk to and agreed to an elcs without dispute! He did advice me of the risks, which he said he was duty bound to go through but other then that put up no objection, at one point even saying to me "it's ok, you don't have to convince me further!"

I am now booked in for the 19/4 and feel a huge sense of relief. It's taken a massive weight of my shoulders, although I still of course feel a bit scared and anxious about the whole procedure and the outcome, but I feel it's the best option for me. Thanks again to all who have support me on this, it really does mean so much to me

I've just come across this thread and was preparing to add my voice to the chorus! But I'm very glad to see you've had a good meeting with the consultant and can hopefully be a bit more at peace for these last few weeks.

FWIW I had a CS for failed induction and it was a lovely experience. Paracetamol and diclofenac saw me through the post-op days and DH got an hour of blissful one-on-one cuddles with DD while I was being fussed over by my lovely midwives in recovery.

Best of luck and congrats on coming to the right decision for you

Well done, bearberry. Glad the consultation went well and the doc was sympathetic. All the best for the 19th - not long to go so hold on in there! X

Well done you! What a relief.

I am so very glad for you

You're not flakey at all. You've had an appallingly traumatic experience and are naturally anxious. It'd be a miracle if you weren't tbh.

In terms of risk, it goes:

Uncomplicated vb
Elcs
Then complicated vb/emcs

But depending on circumstances an emcs can be way less traumatic than a complicated vb. The problem is you don't know what you're going to get in advance.

What you do is entirely up to you of course but if you want a Cs, then insist on one - you have a right to. Obviously the uncertainty is a huge source of anxiety to you and having a booked planned date could alleviate that.

You don't need to justify it to anyone, quite frankly, although you may need to be pushy with the medical team. Tell them you want a section (if you want one) and don't back down.

I'm sorry for your previous loss and I hope you get the birth you want.

Good :)

I had an elcs due to placenta and vasa previa. I was absolutely shitting myself the last few weeks in case I went Into premature or rapid labour - my mum had all of us in under two hours each. Knowing I had a target date to get to was a huge source of comfort.

Take a breastfeeding cushion in with you - it helps to take the pressure off the scar!

Good luck!!

Thanks all

outputgap and Pacific - thanks for such lovely posts through out x